Cunningham v. Blackwell

District Court, E.D. Kentucky·Decided July 11, 2023·No. 3:20-cv-00008·Unknown

Opinion

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF KENTUCKY CENTRAL DIVISION FRANKFORT DR. LARRY CUNNINGHAM, )

) Plaintiff, Civil No. 3:20-cv-00008-GFVT-EBA )

) v. ) MEMORANDUM OPINION ) DAVID W. BLACKWELL, et al., ) &

) ORDER Defendants. ) ) *** *** *** *** This matter is before the Court on supplemental briefing submitted by Dr. Larry Cunningham and Dr. David Blackwell on one of Dr. Cunningham’s defamation claims. [R. 165; R. 168.] In his role as provost of the University of Kentucky, Dr. Blackwell issued a Statement of Charges against Dr. Cunningham that alleges four misdeeds. Dr. Blackwell invokes Kentucky’s doctrine of qualified privilege as to these four statements, which insulates supervisors from liability for making some false remarks in the employment context. To overcome this privilege, Dr. Cunningham claims that Dr. Blackwell knew or recklessly disregarded the possibility that the four allegations were false. Dr. Cunningham has only adduced genuine evidence that Dr. Blackwell spoke maliciously in issuing one of these statements. Accordingly, the Court will issue summary judgment in favor of Dr. Blackwell as to three of the allegations but allow a jury to decide whether Dr. Blackwell can invoke the qualified privilege as to his statement that Dr. Cunningham stole from the University of Kentucky. I The University of Kentucky employed Dr. Larry Cunningham as both a medical doctor and a licensed oral surgeon from 2001 through July of 2019. [R. 63-4.] During that time, Dr. Cunningham treated patients at an off-campus Faculty Clinic operated by UK. Id. at 2. Through

the University’s Dental Service Plan, Dr. Cunningham could receive a portion of the fees paid to UK if he was designated as the Treating Provider for a given patient. Id. at 4–5. Sometime in 2017, someone changed the policy that governed whether Dr. Cunningham would receive that designation.1 Id. at 6; [R. 143 at 4–5.] Dr. Cunningham, then, changed his documentation practices to ensure that he would receive compensation. [R. 92 at 9.] Whether UK validly changed its policy and whether Dr. Cunningham truly should have been the Treating Provider for these patients are issues that remain disputed. [R. 118 at 21 n.14.] At UK’s Faculty Clinic, faculty dentists and resident dentists would both see a patient through the course of treatment. [R. 63-4 at 3.] To further their training, the residents conducted faculty-supervised consultations with patients and documented the care. Id. Prior to 2017, a UK

guidance document approved by the UK Dental Care Board required billing staff to designate the faculty member as the Treatment Provider for patients when a resident helped a faculty member with treatment and documented the care.2 [R. 63-4 at 6.] If Dr. Cunningham was a patient’s Treating Provider, he received forty percent of the bill. [R. 63-4 at 4.]

1 The parties dispute who changed the policy.

2 The 2013 document reads, in full:

If a patient is appointed to a particular Faculty member or Faculty Clinic, and a Faculty member provides care to the patient, billed charges will be recorded with the Treatment Provider listed as the provider number of the Faculty who provided care. These appointments may involve Residents in taking and documenting the patient’s History & Physical Exam and in surgical follow-up evaluations; however, the Faculty member assigned to the patient will still be listed as the axiUm Treatment Provider. Sometime in 2017, UK’s billing employees began designating residents as the Treatment Provider whenever they documented a patient’s care. [R. 63-4 at 6.] Dr. Cunningham claims to have noticed this change in some of his cases by the fall of 2017. [R. 1-2 at 16.] He alleges that the Dean of the College of Dentistry, Dr. Stephanos Kyrkanides, effectively changed UK’s

billing policy without following the mandatory procedures to do so. [R. 63-4 at 6–7.] Dr. Kyrkanides denies this version of events. [R. 143 at 6; R. 146 at 1.] Dr. Kyrkanides asserts that the UK Dental Care Board revised the policy in November of 2017. [R. 143 at 5.] Regardless, everyone agrees that Dr. Cunningham changed his documentation practices around this time. [R. 63-4 at 9; R. 92 at 9.] From April of 2017 through July of 2018, UK designated a resident as the Treatment Provider for eighty-nine patients that Dr. Cunningham alleges he treated. [R. 63-4 at 37; R. 63-21.] Dr. Cunningham believed that he was entitled to income for these patients under UK’s existing policies, even though a resident wrote the documentation for their treatment. [R. 63-4 at 9–10.] Accordingly, he reviewed the files and removed any reference to a resident from the notes for these patients. Id. at 10. Dr.

Cunningham’s colleague, Dr. Shehata, also engaged in this practice. Memorandum in Support of Motion for Summary Judgment at 11, Shehata v. Blackwell, No. 3:20-cv-00012-GFVT (E.D. Ky. June 26, 2021), ECF No. 71-4. The altered records triggered an investigation within the University. [R. 71-4 at 10.] At the time, Dr. Blackwell served as UK’s Provost. [R. 92 at 14.] UK Compliance officials interviewed seven residents whose notes Dr. Cunningham changed. [R. 62-9 at 292.] They all confirmed that treatment at the faculty clinic occurred in two ways. Id. Sometimes the residents

Notice of Filing, Attachment McConnell Deposition at 161, Shehata v. Blackwell, No. 3:20-cv-00012-GFVT (E.D. Ky. June 17, 2021), ECF No. 70-1. UK disputes both the applicability of this document to the patients at issue and whether it constitutes formal University policy. [See R. 63-4 at 5 (“As a purely advisory body, the UKDCB lacks authority to create or enforce rules, absent the Dean’s approval.”).] would treat the patient and present their findings to Dr. Cunningham, who would then go in and reevaluate the patient. Id. Alternatively, the resident and Dr. Cunningham would treat the patient at the same time. Id. Regardless, none of the residents recalled an occasion when a patient left without seeing Dr. Cunningham. Id.

Based on the investigation, Stacey Moore, the compliance manager for the College of Dentistry, drafted an internal report in 2018. See id. at 291–92. Ms. Moore concluded that there was no patient care issue. Id. at 292. Instead, the issue was purely with the documentation. “[G]iven that the documentation in the record appears that [sic] . . . Dr. Cunningham saw the patient without a resident, the medical record does not reflect the services that were performed.” Id. Ms. Moore believed that Dr. Cunningham deleted references to the residents “purely to obtain credit for these visits.” Id. After the investigation concluded, Dr. Blackwell decided that UK needed to discipline Dr. Cunningham. [R. 92 at 14.] Dr. Blackwell arranged a meeting with Dr. Cunningham in January of 2019 to inform him that the University would commence termination proceedings based on

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